Healthcare Provider Details

I. General information

NPI: 1386820777
Provider Name (Legal Business Name): BEXAR COUNTY JUVENILE PROBATION DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2008
Last Update Date: 01/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 E MITCHELL ST REIMBURSEMENT OFFICE
SAN ANTONIO TX
78210-3844
US

IV. Provider business mailing address

235 E. MITCHELL ST. REIMBURSEMENT OFFICE
SAN ANTONIO TX
78210-3845
US

V. Phone/Fax

Practice location:
  • Phone: 210-531-1000
  • Fax:
Mailing address:
  • Phone: 210-531-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number17416
License Number StateTX

VIII. Authorized Official

Name: DAVID J REILLY
Title or Position: CHIEF JUVENILE PROBATION OFFICER
Credential:
Phone: 210-531-1813